NKTI Division of
Urology, Urologist's Training Services

The NKTI Urology
Training Program

Pre-Requisites
for Application:

Certificate that the applicant has completed at least two years of
General Surgery residency, properly accredited by the Philippine Board of Surgery

Philippine Regulatory Commision Medical Board Rating

Photocopy of applicant's Medical License

Photocopy of Medical School Diploma

Certified True Copy of Transcript of Records of the applicant's medical
school

At least two Letters of Recommendation

Properly accomplished Application Form with two 2x2" pictures

A written exam consisting of multiple choice and
fill-in-the-blanks questions on both Urology (50%) and General Surgery (50%) will be given
to all applicants. Three separate personal interviews will be conducted by 3 different
consultants. Consideration and ranking of applicants will be based on (in no particular
order):

Interview mean.

Written exam score

Letter of Recommendation

Other factors.

The NKTI has its own General Surgery training
program. However residents in that program who wish to enter the Division must apply in
the same fashion and take the same risks as applicants from other institutions. No
particular advantage is technically alloted to NKTI GS residents.

The program consists of four years of Urology
residency. Depending on the available slots, two to three first year residents are
selected. The residency training program is designed with a step-ladder approach, such
that for each year level, duties and responsibilities as well as the complexity and
difficulty of surgical procedures are increased gradually.

First Year:

During the first year, the main training objective
is the diagnosis and management with pre- and post-operative care of Urological patients.
As such, the first year resident, in theory, does not scrub into any operative procedure.
The first year is divided into a Ward rotation, an Xray rotation, and an OR rotation (if
there are 3 first year residents). The Ward Rotator is in charge of all ward referrals.
These include admissions, referrals from other departments, emergency referrals, referrals
for adverse events on patients in the ward or ER, facilitation of laboratory work-ups and
results, etc. The Xray Rotator is in charge of all radiographic and other imaging studies
done on all patients. These include the procurement of plates, performance of special
radiographic procedures (voiding cystourethrograms, retrograde urethrograms, cystograms,
transrectal ultrasonograms, etc), and urodynamic studies. The OR Rotator (if there is a
3rd first year resident available) is tasked to assist in any and all operating room
procedures as needed. The rotations are divided equally among the first years and are
rotated throughout the year. In addition to this, for one month of the first year,
the resident is sent to St. Luke's Medical Center Stone Treatment Center for a rotation in
Extracorporeal Shock Wave Lithotripsy, where he learns to assess patients for lithotripsy,
isolate the stone, conduct the treatment itself, and follow-up each patient.

Second Year:

The main training objective for the second year is
to master basic surgical skills and technique, to assist in open surgical procedures, and
to learn basic endourological procedures. The Second Year resident is the main workforce
of the operating room. A second year must scrub in all open procedures done by the
Division and is in charge of the compliance of all pre- and post-operative records, such
as the Pre-Op Notes, Post-Op Notes, Histopathologic Form, Operative Technique, Post-Op
Orders, Logbook of Operations, etc. He is also allowed to do some of the simpler open
procedures like cystolithotomies, proximal and middle ureterolithotomies, and
orchiectomies. The Second Year is also responsible for presenting at hospital-wide
conferences like the CPC (Clinico-Pathological Conference) and the Hospital Tumor Board.
For four months, the Second Year resident rotates at the UP-PGH (University of the
Philippines-Philippine General Hospital) Medical Center specifically for urologic trauma,
minor open procedures, and infertility and sexual dysfunction, aspects of urology which
are less prevalent at the NKTI.

Third Year:

The Third Year's main training objective is to
master major open Urological procedures and to assist in more advanced cases. All open
surgeries, except for cancer, plastic/reconstructive, transplant and pediatric procedures
are the main responsibility of the Third Year. They also assist and supervise the junior
residents in all endoscopic, minor or open procedures that they do. They are also the main
assistants for consultant's open procedures. The Third Year is also responsible for the
day-to-day conduct of the In- and Out-patient areas.

Fourth Year:

The fourth year's training objective is to master
all advanced Urological procedures, including radical cancer surgery, transurethral
resection, plastic/reconstructive, and pediatric cases. One Fourth Year is chosen as the
Chief Resident and his role is supervisory to all the more junior residents. The Chief
Resident has prerogative in the assignment and scheduling of all urologic cases,
disciplinary actions, interdepartment affairs, etc.

Rotators
from other Institutions

One thing that makes the Division unique among the
other Urology training programs in the country is the wide array of diagnostic and
therapeutic facilities that it can offer to its charity patients at an affordable rate.
This offers residents-in-training a great deal of opportunities for direct hands-on
experience to learn such procedures than if they merely observe. As such, the Division
would gladly accept rotators from other institutions both local and abroad, and has been
doing so since its inception. Currently regular rotators from the Philippine General
Hospital (1st year Urology), Jose Reyes Memorial Medical Center (4th year Urology), East
Avenue Medical Center (2nd year Urology), University of the East - Ramon Magsaysay Medical
Center (3rd year Urology), and Manila Central University Hospital (3rd year General
Surgery). This doesn't include the 2nd year General Surgery residents of NKTI who also
rotate at the Division. Occasionally, the Division has rotators from abroad who observe
operations that are seldomly done in their respective institutions, such as open stone
surgery of the urinary tract.

For those
institutions who are interested in rotating their own trainies to the Division, kindly
send a letter of intent addressed to: